Active NPI
Jordan Matthew Wheat, MS, LAT, ATC
- Athletic Trainer
- Desoto, TX
National Provider Identifier
1003599135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000019148
- Practice address
- 700 Eagle Dr
Desoto, TX 75115-6004 - Phone
- (972) 979-0527
- NPI assigned
- Aug 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT6192 | TX | |
| Athletic Trainer | 2255A2300X | 2000019148 | Primary |
Addresses
Primary practice location
700 Eagle Dr
Desoto, TX 75115-6004
Mailing address
4207 Hideaway Dr
Arlington, TX 76017-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT6192 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1003599135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 HIDEAWAY DR",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760173300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 EAGLE DR",
"city": "DESOTO",
"state": "TX",
"postal_code": "751156004",
"telephone_number": "972-979-0527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEAT",
"first_name": "JORDAN",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "MS, LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-07",
"last_updated": "2023-08-07",
"certification_date": "2023-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT6192",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": "2000019148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Desoto, TX
- We Care Moore Non-Emergent Transportation
- Kimberly Weatherton
- Koi D Webster
- Wellness Healthcare Solutions, Inc.
- West Wharton County Hospital District (Five Points Nursing and Rehabilitation)
- Wheelchair Rolls LLC
- Anna White, LCSW
- Judge Whitfield V, LCDC
- Jacqueline Lachalle Whitlock, LVN
- Carole Marie Wilcher, LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.